The following article is my “Cliff’s Notes” version of The Price of Panic by Axe, Briggs, & Richards. It was published in mid-2020. The book is about 200 pages long. It’s heavily-endnoted. This version is only about 3000 words long, and I make no attempt to cite any of their endnotes. My additions for clarification are in [brackets].
I tried to snag all their important points, but if something seems missing, you’ll have to read the book yourself. I’ll even send you my copy, if you promise to pass it along to someone else when you’re done.
Chapter 1 - Where Did the Panic Start?
3 - We knew early on that many people, especially children, seemed to catch the virus and develop antibodies without ever showing symptoms.
4 - And the day after [a certain presidential tweet], he [President Trump] declared a national health emergency and began restricting travel from China, as Tom Cotton had suggested.
4 - Trump’s political and press critics accused him of xenophobia. Speaker Nancy Pelosi was urging tourists to come to San Francisco’s Chinatown in late February. Within weeks, though, the same critics would be complaining that Trump should have acted sooner.
8 - At the time of this writing, we can’t settle these mysteries [as to origin].
Chapter 2 - Who Started the Panic?
10 - The guy directing the global response to the coronavirus was a long-time communist who wanted socialized medicine worldwide.
11 - “The possibility of limited human-to-human transmission cannot be excluded,” the [WHO] bulletin [in January, 2020] said, “but the risk of sustained transmission is low.”
12 - [WHO] had pushed a model from the Imperial College London that projected forty million deaths from the virus worldwide. This model - a piece of landmark guesswork - was the source of the shocking but bogus claim that 3.4 percent of coronavirus infections were fatal. That’s a good thirty times more deadly than the flu in a severe season. Policymakers should have been skeptical. Instead, that became the basis for their response.
13 - Without WHO, then, the pandemic panic might never have gone global.
13 - No one should doubt that the main models, and government officials who trusted them, played an oversized role in creating the panic.
13 - The problem came when the press, public health advisors, and political leaders all accepted these models uncritically and relied on them in their reporting to the public and in their public policy decisions.
14 - It’s not the job of immunologists, epidemiologists, and other narrow experts in the bowels of the administrative state to make policy decisions.
14 - Add to this problem the incentives that influence a public health official such as Anthony Fauci. For career safety, it’s much better to overstate than to understate the risk.
16 - It’s [the flatten the curve graph] a compelling image, but it’s also far too simple. We should not compress healthcare capacity into a single number.
17 - Quantifying this vast and varied collection of resources in one number is unrealistic.
17 - But total cases is the wrong thing to focus on if the concern is hospital capacity. For that we should instead focus on the fraction of cases that require treatment. Nobody had a good estimate of that when these models were being used to scare everyone in March. Only later did we realize how small this fraction was.
Chapter 3 - How It Spread
22 - We aren’t suggesting that the coronavirus was just like the flu. It wasn’t, as we’ll see later. Our point is that a blizzard of breathless reporting every hour for weeks on end could whip up a decent panic over the flu every year, if we had the stomach for it.
23 - And there was another pathway to panic - fixating on “cases.”
24 - Most people who tested positive for the virus were very unlikely to be killed by it. Yet officials used these tests to inflate the COVID-19 death numbers.
24 - As testing expanded, the number of people who had tested positive (and negative) for the virus went way up, even as deaths went down.
24 - If deaths were dropping across all age groups, how were “cases” rising? Well, no doubt the bug was still out there. But a parallel drop in deaths among everyone from young adults to people in their late eighties and nineties suggests that the virus had come close to running its course.
25 - The basic point is that both the number of active cases and the number of deaths from the virus can be exaggerated.
25 - The obsession first with the fatality rate, and then with the cases, was a prescription for panic. Attention to the mean age and health of victims and comparisons to prior pandemics that hadn’t provoked panics would have been much healthier medicine.
31 - At the height of the coronavirus, countless people were trying to track the precise number of deaths in real time. That’s something that no one had done for a flu-like illness before, because it can’t be done. The uncertainties at that level of resolution are so vast that the effort was bound to be an exercise in self-deception. Add in media hype, and it also became an exercise in mass panic.
Chapter 4 - Social Manias and the Cult of Expertise
33 - Why didn’t that [swine flu] create a panic? One key difference is the growth in size and power of social media.
36 - In reality, most people, including most journalists, know diddly about ventilators, or epidemiological models, or complex cost-benefit analyses, or viral infections.
36 - Our point is that during the pandemic, social media platforms tended to dilute real expertise and allow people without expertise to spread panic by assuming a spurious authority there.
43 - The social media giants propped up people who were on the side of a manufactured consensus, whether or not they were experts. And they suppressed people who were on the other side, whether or not they were experts. This made the pandemic not just scary, but creepy.
Chapter 5 - Rush to Lockdown
46 - What we found perplexing was that, at first, few people opposed these restrictions. On the contrary: more often than not, the public took part, and even led the way.
47 - What made all the difference was this: we thought the lives of other people were at stake.
50 - As in jiu jitsu, authorities used our moral weight to hoist us by our own petards. We’ll show later why this move wasn’t fair play. If we all had grasped how much harm the panicked lockdowns would do to others, we surely would have been less compliant.
Chapter 6 - Untangling the Numbers
53 - So they [the experts] had good reason, conscious or not, to exaggerate COVID-19 deaths. And if the real numbers ended up far below the forecasts, they would want to credit the shutdowns for the drop. The last thing they’d want to do is admit a colossal “oops.”
62 - If there’s a spike in new cases when the deaths are plummeting, it’s almost certainly because there’s more testing.
73 - COVID-19 will go down in history, but not for the number of deaths it caused…. All death brings pain, but as far as historic pandemics go, the coronavirus was unremarkable.
73 - By the end of May 2020, COVID-19 might have claimed as many [lives] as the swine flu.
74 - Whatever led to the unprecedented shutdown of the world economy and curtailment of rights in the coronavirus panic, it wasn’t a historic number of deaths.
Chapter 7 - Blind Models
75 - History shows that you will rarely lose your job making predictions if you’re wrong in the right direction. On the other hand, you may well lose it if you’re right in the wrong direction.
76 - But this was not what the leaders of most countries wanted to hear. Elites don’t tend to welcome the news that the best thing they can do is stand aside, that their gifts are unwelcome and their interference may even cause harm. So they didn’t hear it. The non-alarmist models were right in the wrong direction. They favored instead the alarmist models, which were wrong in the right direction.
80 - Even well into the crisis, when other experts had savaged the Imperial College model, authorities and media were still citing it. We expect lockdown champions to keep this up for years. Officials will keep quoting it because it’s the only argument they have that they saved millions of people whom the virus would otherwise have killed. But let’s be clear: that use of the model is political, not scientific. There are well-known scientific ways to judge the performance of models. By any of those measures, this early forecast was an abysmal failure.
97 - We need to dry up this market for the impossible [expecting unattainable accuracy] - at least among the class that makes the rules we have to obey. If we don’t, it will continue to leave death and destruction in its wake.
Chapter 8 - Why Did We Believe Lockdowns Would Work?
103 - Almost everyone assumed they [the lockdowns] would work. WHO, in contrast, concluded: not so much [in October, 2019].
103 - Hand washing makes sense, but studies haven’t shown that it works.
104 - Face masks also make sense, though they’re much more of a hassle. Again, though, when it comes to people without symptoms wearing them in public, “there is no evidence that this is effective in reducing transmission.” [quotation from WHO]
Perhaps most controversially, WHO reported, “Travel-related measures are unlikely to be successful in most locations because current screening tools such as thermal scanners cannot identify pre-symptomatic infections and afebrile infections, and travel restrictions and travel bans are likely to have prohibitive economic consequences.”
They also warned that “social distancing measures (for example, contact tracing, isolation, quarantine, school and workplace measures and closures, and avoiding crowding) can be highly disruptive, and the cost of these measures must be weighed against their potential impact.” Moreover, they may do less than most people assume. They judged the quality of evidence supporting the value of these measures to be “very low.”
Lockdowns, they said, can even spread disease, since “household quarantine can increase the risks of household members becoming infected.”
110 - We don’t know whether cloth face-coverings do much good in real use. We do know that there is no strong evidence that they do. And there is evidence that they could do more harm than good in some cases. For one thing, they’re easy to contaminate.
110 - In the end, face coverings may have been as much about signaling and social control as about science and safety.
Chapter 9 - Did the Lockdowns Work?
111 - The first warning signs came in April. Officials had predicted a huge surge in COVID-19 cases and deaths even with lockdowns. But the predicted surge didn’t come - thank God. Unfortunately, we had devastated our economy and harmed millions because we trusted the predictions.
112 - Within a few weeks the mantra changed from “flatten the curve” to “stop the spread.” Just a short time before, no one had thought we could stop the spread, as a Live Science article from March 16 explained: “Health officials take for granted that COVID-19 will continue to infect millions of people around the world over the coming weeks and months…. A flatter curve...assumes the same number of people ultimately get infected, but over a longer period of time.”
113 - So did the lights go out on coronavirus in the UK [which locked down], or at least dramatically dim? Not at all.
114 - Of course, we can imagine that the curve could have looked worse without the lockdown. But this is storytelling. The actual numbers show no clear break in the trend where it clearly should have broken if the lockdown had altered the course of the outbreak.
115 - Since about 80 percent of infections cause mild or no symptoms, the vast majority of infected people likely went untested and therefore unrecorded. This means the real number of infections in the UK after lockdown can easily have been over a million. So the lockdown didn’t come close to stopping the spread.
116 - And what do we find [in the states of the US]? As in the UK, mandated lockdowns seem to have had little effect on the spread of the coronavirus. Though no state did a 180-degree policy change like the one in the UK, the curves are broadly similar.
125-126 - So what can we conclude from this survey of countries [around the world]? Only one thing: we do not know that lockdowns worked, that is, that they reduced deaths. We can’t prove the opposite either - that they made no difference in the death rate. But the proof has to rest with those who would call for lockdowns. Otherwise, almost any claim of a looming disaster becomes a ready excuse to proclaim something like martial law, provided a few experts can be lined up to warn that the sky is falling. To justify their calls for lockdowns, advocates need to show - not just assume - that lockdowns really do save enough lives to justify the human cost. They haven’t done that.
On the contrary: several no-lockdown countries had low death rates. Given the low death rates in several of the no-lockdown countries and states, and the graphs showing the death rate curves, it will be almost impossible to prove the lockdowns made much difference.
126 - So we’d like to think it was worth it. But if the economic and human costs vastly outstripped the benefits, we need to face the fact and chart a better course, should something like this pandemic happen again, as it surely will.
Chapter 10 - The Human Cost
135 - To make a long story short, the lockdown hit the people and businesses that could least afford it the hardest.
137 - We can’t yet prove that pandemic panic led to net spikes in these deaths of despair [suicides]. Still, the stories started appearing at once, even in media outlets that supported the lockdowns.
138-139 - In other words, more people around the world could die every two days from our response to the pandemic than those who died from the entire pandemic itself.
142 - While experts will debate exact numbers for the next several years, the numbers here are so large that we have no doubt that the lapse in care will end up costing many lives.
146 - The eight-hundred-page CARES Act involved all manner of economic meddling, but at least it was aimed at helping Americans who had lost their jobs. The arbitrary attacks on religious freedom were another thing entirely. Governors declared churches and places of worship non-essential, and churches closed their doors in service to the common good. But then the lockdowns went on and on and on, and the bias against churches became more obvious. In mid-May, for instance, Minnesota governor Tim Walz allowed tattoo parlors, malls, and even casinos to reopen, but not churches.
152 - Whether or not lockdowns somewhere slowed the spread of the virus, we must judge the panic and the lockdowns by both successes and harms. The real costs of the panic and lockdowns, short and long term, vastly exceeded the benefits.
Chapter 11 - Life, Death, and the Pursuit of Happiness
154 - In the panic over the pandemic, in contrast, authorities seemed to be guided by a narrow goal that no sane society would embrace: namely, prevent wherever possible every coronavirus casualty, no matter the cost in lives or fortune. This was a deeply misguided goal.
155 - Our government doesn’t guarantee us happiness - only the right to pursue it. Much less can it guarantee perfect safety to us all. No one can live a risk-free life. And at some point, everyone dies. However we think about public health, we should not forget those two facts.
Of course, we’re not saying that the state has no role to play in public health. But public health officials left to their own devices are not likely to get the balance right. They’re bound to maximize safety, to the neglect of other goods.
157 - The problem is not expertise. We all benefit from experts. The problem is the tyranny of experts - when their narrow, professionally biased thinking dictates policy for everyone.
161 - This is one reason the one-size-fits-all policies made no sense. There’s a vast difference between a disease that kills indiscriminately - the old and the young, the healthy and the infirm - and a disease that mostly causes or contributes to the deaths of people near the end of their lives.
161 - The point is not that we should sacrifice the lives of the old and frail for the young and healthy. We shouldn’t. Rather, as a matter of public health, we should make sure that the costs of our interventions don’t vastly exceed the benefits.
162 - The predictable refrain, of course, is that the pandemic would have claimed far more lives without the lockdown. But as we have seen, the evidence strongly suggests otherwise.
Chapter 12 - Through a Glass Darkly: Balancing Costs with Benefits When We Don’t Know the Future
165 - The choice isn’t between letting some people get killed or preventing their deaths by killing other people. Rather, we want to make sure that, as a matter of policy, our response matches the risk involved, because either inaction or overreaction could lead to more deaths and harm.
165 - No thinking person treats safety as the only good worth having. No thinking society does either. “Doing everything we can to save just one life” would justify banning all forms of travel, all sports, all potential allergens, and all person-to-person contact, including handshakes.
166 - In the same way, there are trade-offs, and opportunity costs, both to accepting and to avoiding risk. This side of glory, there’s no such thing as zero risk - only more or less risk. So, the question we should be asking about any recommended response: Do the likely gains outweigh the costs - at least the ones we can foresee?
Chapter 13 - Who Got It Right?
[As of the writing of the book, here is the short list. This may have changed over time.]
Taiwan, Sweden, Japan, South Korea, Iowa, Oklahoma, Nebraska, North Dakota, South Dakota, Arkansas, Utah, and Wyoming.
Chapter 14 - Lessons Learned
187 - If we had all focused on what we knew, up close and personal, things might have unfolded differently. If the experts scream that the sky is falling, and yet it stays put when you take your walk, then you might not want to treat their advice as gospel.
187 - The fact is, we almost always have more time than they are telling us. And in most cases the panicked response is not going to be the ideal response. If a credible authority calls for prompt, reasonable action, by all means get on board. But don’t be stampeded into imprudent choices. And if, in hindsight, the call was wrong, demand a change in course.
187 - [Heading] Take Care of the Most Vulnerable
188 - [Heading] Take Models and Predictions with a Pinch of Salt
189 - [Heading] Beware the Overconfidence of Experts
190 - [Heading] Choose Freedom over Central Planning
191 - [Heading] Take Traditional Media Cautiously
193 - [Heading] Make Social Media Accountable
Conclusion - Against the Brave New Normal
197 - In their panic, most Americans supported the lockdowns. We were inspired not by mere deference to authority, but by fear and a concern for others. Cities, states, and the federal government overstepped their bounds. And it wasn’t okay just because most people agreed to it. That’s why our basic rights - to assemble, to exercise our religion freely, and so forth - are enshrined in the Constitution. That guarantee is crucial because the government, riding some rising wave of public opinion, will always be tempted to disregard the rights of even a balky and resistant minority.
203 - If we don’t learn the right lessons from the 2020 pandemic panic, though, it [the Brave New Normal] could sneak up, settle in, and cost us our lives, our fortunes, and our sacred honor.
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